60 percent of people who died of Covid were above 60Public health experts say infected people are staying home until their condition deteriorates and this is making it difficult to save people with co-morbidities.
The number of people dying from Covid-19 and the daily number of new cases has declined in the country, officials say. They also say that quarantines and isolation facilities set up for Covid-19 patients, which once used to be fully occupied until a month ago, have all been deserted now.
Officials working for various agencies under the Ministry of Health and Population, who used to keep their phone busy to avoid answering distress calls from the kin of infected patients now say they hardly get calls for beds these days.
The new changes have come after the government stopped providing free tests to asymptomatic patients and tracing the contacts of infected people. If claims by officials at the Health Ministry are to be believed, the pandemic is now under control in the country.
However, that’s not the case, experts say, pointing at the number of people queuing up to get to intensive care units and ventilator support, and the number of senior citizens with co-morbidities dying from coronavirus infection.
“Patients are seeking hospital care only after they become critically ill,” Dr Ajaya Thapa, chief of the Emergency Department at Dhapasi-based Grande International Hospital, told the Post. “More patients are dying these days due to delay in reaching the hospital. It will be difficult to save people when they come to the hospital only after their condition has gotten serious.”
Doctors say neither the risk of infection has declined nor have the death and infection rates. What has only declined is testing, and the level of responsibility taken by authorities concerned to tackle the pandemic.
Of the 1,567 people who have died due to Covid-19 until Friday, 950 (around 60 percent) were above 60 years old. According to the Health Ministry, 27.5 percent of the people who died of the infection fall in the 40 to 60 age group.
“A lot of people might be dying from the infection at home, as people have stopped seeking tests and treatment, unless they become seriously ill,” added Thapa.
On Sunday, 6,495 tests were performed throughout the country. Only 6,074 tests were performed on Saturday.
Experts say that official death rate figures have declined as the government has directed agencies concerned not to perform tests to establish the cause of death of the deceased. There is also a discrepancy in the numbers reported by the Health Ministry and those by the army that manages the bodies of people who die of the disease.
Public health experts have been warning for a long time that the death rates will go up once the infection spreads into the community and people above 60 and those with underlying conditions get infected.
“We have been saying since the beginning that the death rate will go up and elderly people and those having comorbidities are highly vulnerable to coronavirus,” Dr Kiran Pandey, consultant physician at the Hams Hospital, told the Post. “We should think about saving elderly people and those with underlying conditions from getting infected.”
Instead of increasing tests and making contact tracing effective, the government stopped providing free testing and halted contact tracing. After the Supreme Court ordered the government to provide free testing, the Health Ministry agreed to do so, but only for those who show symptoms of the disease. Doctors say that as over 70 percent of people are asymptomatic, chances that the disease will spread from asymptomatic is high as the government has stopped contact tracing.
According to Pandey, underlying conditions—high blood pressure, diabetes, obesity, renal and heart problems and age have been found to have compounded risks in Covid-19 patients.
Several studies, including Nepal Burden of Disease 2017 and the Population-based Prevalence of Selected Non communicable Diseases in Nepal show that heart disease, chronic obstructive pulmonary disease, lower respiratory infection and stroke among others are major killer non-communicable diseases in the country.
Population-based prevalence studies of selected non-communicable disease shows that 12 percent of the population of the country suffer from chronic obstructive pulmonary disease, eight percent from diabetes, six percent from chronic diseases, and three percent from coronary artery disease.
Dr Roshan Pokhrel, chief specialist at the Health Ministry accepts that saving elderly people from coronavirus infection has become a challenge.
“Those having symptoms and co-morbidities should go to the hospital at the earliest,” said Pokhrel. “More people are dying due to delay in going to hospital.” He conceded that asking people not to go to hospital until it’s an emergency, was wrong.